Provider Demographics
NPI:1437140720
Name:TEAT, RODERICK D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:D
Last Name:TEAT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1352 BRAEBURN RD NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-8803
Mailing Address - Country:US
Mailing Address - Phone:704-795-7408
Mailing Address - Fax:
Practice Address - Street 1:1352 BRAEBURN RD NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-8803
Practice Address - Country:US
Practice Address - Phone:704-795-7408
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC141321835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy